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Victoria Midwives Protocol - Observations in labour

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These are easy to read and understand and are beautifully presented.

I have recently been asked about the observations taken during labour by midwives attending homebirth. I can only speak of births that I have been involved in, and midwives with whom I have worked.

The usual practice in Victoria within the Midwives in Private Practice (MIPP) group is to have a second midwife meet the woman and her partner prior to the birth, and attend the birth with the primary care midwife, providing support as needed.

Women who give birth at home are a pretty diverse group, and not all those who would be classified as "low risk" by hospital standards. For example a woman may be considered too old, too short, or too fat to be under midwife care in hospital units. They may have had a previous caesarean section birth. It is my responsibility to advise the woman on the factors in her situation that may increase her need for obstetric intervention, and to make it clear to her under what circumstances I would recommend medical care. The woman may not accept my advice, and this is dealt with in our Code of Practice (Code of Practice for Midwives in Victoria 1996). The big difference between home and hospital care is continuity of care. The midwife and the mother know each other, so observations are of the whole person, as well as T, P, BP, FH &c.

As a rule my observations in labour are:

Joy Johnston, FACM IBCLC
Independent midwife and lactation consultant
Melbourne, Australia

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This Web page is referenced from another page containing related information about Monitoring Fetal Heart Rate/Decels


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